Application Of Endoilluminator With Duct In Silicone Oil Injection

Objective To evaluate the clinical effects of endoilluminator with duct to exchange fluid/silicone oil.Methods experimental group:To the 36 patients(36 eyes)of complicated retinal detachment,when injecting silicone oil into vitreous cavity after PPV by the manner of silicone oil/liquid exchange,we apply the endoilluminator with duct to execute the function of illuminating and sucking fluid,we connect its duct with suction channel of vitrectomy machine,operator aspirates liquid of the bottom(the perfusate or PFC)of vitreous cavity actively through endo illuminator with duct.At the same time,assistant closes the infusing tube on inferior-temporal sclera incision,insert the 20G vialon veinpuncture cannula into vitreous space through another sclera incision,inject silicone oil into vitreous space gradually.In this process,only 2 sclera incisions are working.Control group:To the 36 patients(36 eyes)of complicated retinal detachment,when injecting silicone oil into vitreous cavity after PPV by the manner of silicone oil/ liquid exchange,we apply the flute-needle as the extrusion needle to drain liquid of the bottom(the perfusate or PFC)of vitreous cavity passively,assistant injects silicone oil into vitreous cavity through the infusing tube on inferior- temporal sclera incision.In this process,all sclera incisions are working.And we record if the process is sucessful,if the intraocular pressure is steady,if the process of fluid (Perfluorocarbon)/silicone oil exchange is complete,and record the complications in and postoperation,etc.Results experimental group:in these operations,we use perfluorocarbon in all cases,2 cases(5.56%)appeared exorbitancy intraocularpressure; 2 cases(5.56%)appeared that silicone oil leakage from the connection;3 cases(8.33%)appeared corneal edema;and no case appeared perfluorocarbon residual;no case occurred silicone oil entered subrretina;all cases were anatomically reattached.With 3 months to 2 years follow-up,31 cases(86.1%) re- attached completely;11 cases occurred cataract and operated in our hospital;7 cases occurred silicone oil emulsification and received silicone oil removing in our hospital.Control group:in these operations,we use perfluorocarbon in all cases,8 cases(22.2%)appeared exorbitancy intraocular pressure;3 cases(5.56%)appeared that silicone oil leakage from the connection;3 cases(8.33%)appeared corneal edema;and no case appeared perfluorocarbon residual;no case occured silicone oil entered subretina;all cases were anatomically reattached.With 3 months to 2 years followup,30 cases(83.3%)reattached completely;9 cases occurred cataract and operated in our hospital;8 cases occurred silicone oil emulsification and received silicone oil removing in our hospital.Through the analysis of SPSS 13.0,in operations,P of exorbitancy intraocular pressure is 0.0409;P of silicone oil leakage from the connection is 0.6429;P of corneal edema is 0.4533;P of retinal reattachement completely 3 months to 2 years postoperation is 0.7593.Conclusions Application of endoilluminator with duct and 20 G veinpuncture cannula to inject silicone oil into the vitreous cavity,it shows that intraocular pressure can be control better,it can decrease the injecting resistance,it can complete the fluid/silicone exchange.and this way is an effective and feasible way of injecting silicone oil into vitreous cavity.